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目的:探讨经支气管镜氩离子凝固术治疗伴有咯血的晚期中心型肺癌的疗效。方法:选取2011年12月-2013年6月期间我院收治的晚期中心型肺癌咯血的患者60例,将其随机分为观察组(30例)和对照组(30例),观察组给予经支气管镜氩离子凝固术联合全身化疗,对照组给予经支气管镜介入局部用药联合全身化疗,对比两组患者治疗后的临床疗效、24h动脉血气分析、肺功能、止血有效率及治疗后3天、3~7天,7天复发率以及总复发率和不良反应情况。结果:治疗后两组患者的临床症状均得到一定的改善,观察组患者的临床有效率为80.0%(24/30)显著高于对照组的56.7%(17/30),差异具有统计学意义(P<0.05);观察组患者在发热、呼吸困难、咳嗽、胸痛及咯血等方面的症状缓解率均显著高于对照组,比较差异均有统计学意义(均P<0.05);治疗后观察组肺功能和24h动脉血气分析各项指标均显著优于治疗前,观察组患者的的以上指标均显著优于对照组,差异均有统计学意义(均P<0.05);治疗后观察组患者的止血有效率为100%,显著高于对照组的56.7%(17/30),且观察组患者术后3天、3~7天,7天复发率以及总复发率均小于对照组,两组止血有效率和总复发率比较差异均有统计学意义(均P<0.05);观察组患者不良反应的发生率为10.0%,对照组为13.3%,两组相比无显著差异(P>0.05)。结论:经支气管镜氩离子凝固术联合全身化疗治疗老年晚期中心型肺癌咯血具有较好的临床疗效,止血迅速有效,且复发率低,能够缓解呼吸道阻塞症状,改善呼吸功能,是一种不错的选择,值得在临床普遍推广与应用。
Objective: To investigate the efficacy of bronchial argon plasma coagulation in the treatment of advanced central lung cancer with hemoptysis. Methods: Sixty patients with advanced central lung cancer with hemoptysis were selected from December 2011 to June 2013 in our hospital. They were randomly divided into observation group (30 cases) and control group (30 cases) Bronchoscope argon plasma coagulation combined with systemic chemotherapy, control group given by bronchoscopic interventional local chemotherapy combined with systemic chemotherapy, compared two groups of patients after treatment of clinical efficacy, 24h arterial blood gas analysis, pulmonary function, effective rate of hemostasis and 3 days after treatment, 3 to 7 days, 7 days recurrence rate and the total recurrence rate and adverse reactions. Results: The clinical symptoms of both groups were improved after treatment. The clinical effective rate was 80.0% (24/30) in the observation group and 56.7% (17/30) in the control group, the difference was statistically significant (P <0.05). The symptom relief rate of fever, dyspnea, cough, chest pain and hemoptysis in the observation group were significantly higher than those in the control group (all P <0.05). After treatment, The indexes of lung function and 24h arterial blood gas analysis were significantly better than those before treatment. The above indexes in the observation group were significantly better than those in the control group (all P <0.05). After treatment, the observation group The hemostatic effective rate was 100%, which was significantly higher than that of the control group (56.7%, 17/30), and the observation group patients were less than the control group after 3 days, 3-7 days, 7 days recurrence rate and the total recurrence rate (P <0.05). The incidence of adverse reactions in the observation group was 10.0% and in the control group was 13.3%, there was no significant difference between the two groups (P> 0.05). Conclusion: Bronchoscopic argon plasma coagulation combined with systemic chemotherapy for the treatment of hemoptysis in elderly patients with advanced central lung cancer has a good clinical efficacy, rapid and effective hemostasis, and low recurrence rate, which can alleviate the symptoms of respiratory obstruction and improve respiratory function, which is a good Choice, it is worth in the clinical general promotion and application.